Autoimmune hypophysitis: a study of natural course

Background: Autoimmune hypophysitis is a rare autoimmune endocrinopathy. Literature on natural history of autoimmune hypophysitis is scarce.Methods: We prospectively studied patients with autoimmune hypophysitis between January 2013 to June 2015 and all subjects were followed for at least 6 months. Autoimmune hypophysitis was diagnosed based on clinicoradiologic findings. All patients diagnosed with autoimmune hypophysitis were followed every three monthly with evaluation for pituitary functions and six monthly with gadolinium enhanced MRI of pituitary. Deficient hormones were replaced and none of the patients were treated with immunosuppressive therapy or surgery.Results: Ten cases of autoimmune hypophysitis were diagnosed during the study period. Adrenocorticotropin deficiency was the most common (7/10) followed by thyroid stimulating hormone and gonadotropins (each in 5). Pituitary enlargement and stalk thickening were the most common imaging findings. Three patients had recovery of one hormone in each and none of the patients had progression of mass or new hormone deficiency on follow-up.Conclusions: The study describes natural history of autoimmune hypophysitis in 10 patients from a single center. We suggest against the routine use of immunosuppressive therapy or surgery in patients with autoimmune hypophysitis

Abnormalities of thyroid function tests in adult patients with nephrotic syndrome

Background: Nephrotic syndrome is well-known cause of thyroid dysfunction in children; however, there is limited data on this issue in adults, especially regarding natural course of thyroid abnormalities.Methods: Patients with nondiabetic nephropathies were included in the study and evaluated with thyroid function tests at diagnosis and every 2-3 monthly. Age and sex matched healthy volunteers constituted the control group.Results: The study included 39 patients with newly diagnosed nephrotic syndrome and 39 controls. When compared to the control group, patients with nephrotic syndrome had significantly higher thyroid stimulating hormone and significantly lower total thyroxine, total triiodothyronine, free thyroxine and free triiodothyronine levels. Eighteen patients had remission at last follow-up (18.3±3.4 months) and those with remission had improvement in thyroid function tests. Anti thyroperoxidase antibody tended to be more common in nephrotic syndrome patients and among patients with remission, elevated antibodies was associated with persistence of hypothyroidism.Conclusions: Nephrotic syndrome in adult patients is significantly associated with abnormalities in thyroid function tests. All these abnormalities improve with remission of nephrotic syndrome. Patients with elevated thyroid stimulating hormone and anti-thyroperoxidase antibody levels are more likely to progress to overt hypothyroidism and should be closely followed-up or replaced with levothyroxine

Modelování vyzařování do horního poloprostoru z velkých světelných zdrojů

ABSTRACT: Article targets to show potential of software goniophotometer from point of view calculation of the luminous flux leads to upper hemisphere from road lighting system. Basis for this model is building in vyskovice. The thesis further focuses on modeling of radiation in the upper-half space from public lighting system, billboards, cars and windows. The calculation is done for the vyskovice region where the buildings, roads, pavements etc., are designed using AutoCAD as accurate as possible for maximum efficiency of calculation. The purpose of a goniophotometer is to measure luminous intensity or luminous intensity curves. The principle of a goniophotometer is that it allows measuring the luminous intensity in different planes and in different angles, which can be easily interpreted by a sphere with a network of calculation points. The goal of implementing such a network of calculation points is to extend the possibilities of a computational program for modeling the luminous intensity curves of existing luminaires as well as new luminaires. The main goal is calculating the radiation of the luminous flux flowing into the upper half from the outdoor lighting system. Based on the testing, it will be possible to create model of lighting system in city by inserting LDT data of real luminaires. From the resulting model it will be possible to quantify the proportion of the direct and indirect luminous flux flowing into the upper half space.ABSTRAKTNÍ: Cíle článku ukázat potenciál softwarového goniofotometru z hlediska výpočtu světelného toku vede na horní polokouli ze systému silničního osvětlení. Základem tohoto modelu je výstavba ve vyskovicích. Práce se dále zaměřuje na modelování záření v horní polovině prostoru ze systému veřejného osvětlení, billboardů, automobilů a oken. Výpočet je prováděn pro vyskovický region, kde jsou budovy, silnice, chodníky apod. Navrženy tak, aby byly co nejpřesněji využity AutoCAD pro maximální efektivitu výpočtu. Účelem goniofotometru je měření intenzity světla nebo křivek intenzity světla. Princip goniofotometru spočívá v tom, že umožňuje měřit světelnou intenzitu v různých rovinách a v různých úhlech, což lze snadno interpretovat koulí se sítí výpočtových bodů. Cílem implementace takové sítě výpočtových bodů je rozšířit možnosti výpočetního programu pro modelování křivek svítivosti stávajících svítidel a nových svítidel. Hlavním cílem je výpočet vyzařování světelného toku, který proudí do horní poloviny systému venkovního osvětlení. Na základě testování bude možné vytvořit model osvětlovacího systému ve městě vložením LDT dat reálných svítidel. Z výsledného modelu bude možné kvantifikovat podíl přímého a nepřímého světelného toku proudícího do horní poloviny prostoru.410 - Katedra elektroenergetikydobř

Evaluate all newly diagnosed mild-moderate renal dysfunction patients for primary hypothyroidism

Background: Hypothyroidism often presents to nephrologists with elevated serum creatinine which may lead to unnecessary evaluation including renal biopsy.  Methods: We retrospectively analysed the data of 24 patients who presented to the department of nephrology at our institute with anasarca/facial puffiness or elevated serum creatinine and diagnosed to have hypothyroidism with TSH >40 µIU/ml.Results: Twelve patients presented with generalised edema, eight patients for evaluation of deranged serum creatinine and four patients with both generalised edema and deranged serum creatinine. Age (r=0.696, p<0.001) and serum thyroid stimulating hormone (r=0.504, p=0.012) had significant positive correlation with serum creatinine whereas serum total thyroxine (r=-0.637, p<0.001) and triiodothyronine (r=-0.728, p<0.001) had significant negative correlation. Serum sodium was lower (<136 mmol/L) in eight patients. Age (r=-0.598, p<0.001), serum creatinine (r=-0.624, p<0.001), and serum thyroid stimulating hormone (r=-0.728, p=0.012) had significant negative correlation with serum sodium whereas serum total thyroxine (r=0.869, p<0.001) and triiodothyronine (r=.845, p<0.001) had significant positive correlation. Serum creatinine and sodium normalised in all after levothyroxine replacement.Conclusions: To conclude, hypothyroidism is not an uncommon cause of mild-moderate renal dysfunction and often presents to nephrologists prompting unnecessary investigations including renal biopsy. Hence, all newly diagnosed mild-moderate renal failure patients should be tested to rule out primary hypothyroidism

Effect of metformin on fibrinolysis in type 2 diabetes mellitus: an explorative study

Type 2 diabetes mellitus (T2DM) is associated with a high incidence of vascular disease which can cause significant morbidity and mortality. The risk of cardiovascular mortality in T2DM patients is observed to be more compared to the age-matched subjects. This is attributed to depression of the fibrinolytic system which maintains patency of blood vessels. Endogenous inhibitors such as plasminogen activator inhibitor-1 (PAI-1) inhibit the activation of plasminogen and thus prevent the degradation of fibrinogen. In T2DM there is increased levels of PAI-1. Such a state of altered fibrinolysis is attributed to insulin resistance. A previous study done at our institute demonstrated higher euglobulin lysis time (ELT) in T2DM patients than controls, suggesting altered fibrinolytic activity in the former group. D-dimer is a degradation product of fibrin. Its presence indicates a state of hypercoagulability.  In a study by Nwose et al rise in D-dimer levels were observed in diabetics, especially with cardiovascular complications as compared to controls indicating D-dimer could be a useful marker for predicting the complications in T2DM

Impairment in biochemical indices in sprayers exposed to commonly used organophosphorus and pyrethroids: A case study

This study was carried out to evaluate the effect of spraying organophosphate, carbamate and synthetic pyrethroid pesticides on biochemical parameters viz., red blood cell (RBC) acetylcholine esterase (AchE) and plasma butyrylcholinesterase (BChE) activities, oxidative stress parameters viz., plasma T-BARs, catalase activity and antioxidant levels such as reduced glutathione, and α-tocopherol and pesticide residues (analysed using the GC/LC-MS/MS) in sprayers cultivating cotton, chilly and paddy crops in Guntur district for a period of &gt;10 years. The study population included sprayers (120) with a mean age of 37.8 ± 10.8 years and controls (60) with a mean age of 37.3 ± 12.2 years. A significant difference was observed for AchE, BChE activities, thiobarbituric acid reactive substances (TBARs), catalase activity, reduced glutathione and the concentration of pesticide residues in the sprayers cultivating different crops for a period of &gt;10 years as compared to the controls. However, there is no such significant difference observed for α-tocopherol.Key words: Pesticide residues, chronic exposure, biochemical indices,  sprayers running head, biochemical indices, pesticide residues in sprayer

PROTECTIVE EFFECT OF NON-IRRADIATED AND Γ-IRRADIATED MANGO (MANGIFERA INDICA L.) JUICE AGAINST ETHANOL-INDUCED OXIDATIVE STRESS IN ALBINO RATS

ABSTRACTObjective: The aim of this study is to explore the protective effect of non-irradiated and γ-irradiated mango juice (NMJ and GMJ) against ethanolinducedhepatic and renaldysfunctionin rats.Methods: A total of 36 male Wistar rats were selected and randomly divided into six groups of six animals each, and the treatment was given everyday via orogastric tube for 30 days. Group I rats served as normal control group. Group II, III, IV, V, and VI rats received absolute ethanol, NMJ, GMJ,ethanol+NMJ, and ethanol+GMJ, respectively. At the end of experimental period, the animals were sacrificed, and serum was separated for liverand kidney markers analysis. The tissues (liver and kidney) were excised for histopathological changes and lipid peroxidation, enzymatic, and nonenzymaticantioxidantsactivitieswereestimated.Results: Ethanol treatment resulted in the depletion of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione-stransferaseactivities,andreducedvitaminCandreducedglutathionecontent,higherlevelofmalondialdehyde,increasedactivitiesofserumalanineaminotransferase,aspartateaminotransferase,alkalinephosphatase,gamma-glutamyltranspeptidase and elevated levels of serum urea, creatinine,uric acid causing malfunction of hepatic, and renal tissues, when compared to control rats. Mango juice (both NMJ and GMJ) co-treatment with ethanolingested rats, were envisaged to possess significant antioxidant defense properties and help in the recovery of tissues from ethanol-induced oxidativedamage. The results showed that degenerative changes in hepatic and renal cells of ethanolic groups were minimized by the administration of mangojuice, as revealed by histopathological examination.Conclusion: The current findings suggest that treatment with mango juice reduces ethanol-induced oxidative stress, thereby protecting the hepaticand renal tissue from ethanol-induced damage.Keywords: γ-irradiation, Mango juice, Ethanol, Oxidative stress, Antioxidant enzymes, Liver, Kidney

The prevalence of anti-thyroid peroxidase antibodies in subclinica and clinical hypothyroid patients

Background: Subclinical hypothyroidism is a state of mild thyroid failure and is essentially a laboratory diagnosis with elevated serum thyroid stimulating hormone (TSH) and a normal free thyroxine (FT4) concentration. The main objective of study is to evaluate the prevalence of anti-thyroid peroxidise (anti-TPO) antibodies among patients with clinical and subclinical hypothyroidism.Methods: A prospective study was conducted involving 50 patients with biochemical evidence of hypothyroidism. Subclinical hypothyroidism was defined as thyroid stimulating hormone (TSH) >5.0 µIU/ml with normal FT4 and clinical hypothyroidism as free thyroxine (FT4) and high TSH. A detailed history, clinical examination, and investigations comprising of complete haemogram, fasting plasma glucose, fasting FT4, TSH, anti-TPO antibodies and lipid profile were done for all the patients.Results: Out of 50 cases, 28 subjects had clinical hypothyroidism (25 females and 3 males) and 22 had subclinical hypothyroidism (14 females and 8males). Among the 50 subjects with clinical and subclinical hypothyroidism, 33 were anti-TPO positive. The corresponding percentage of anti-TPO positivity noted in the clinical hypothyroidism and subclinical hypothyroidism groups were 80 % and 50% respectively.Conclusions: Serum TSH and anti-TPO analyses are essential in determining the etiology of hypothyroidism and risk of progression to overt hypothyroidism in patients with subclinical.

Optimization, Purification and Characterization of Polygalacturonase from Mango Peel Waste Produced by Aspergillus foetidus

Kora je manga, preostala nakon industrijske prerade pulpe voća, bogata pektinom, pa je upotrijebljena kao podloga za proizvodnju novog enzima, poligalakturonaze. Metodom odzivnih površina optimirano je pet ključnih čimbenika pri submerznom uzgoju plijesni Aspergillus foetidus, i to: omjeri KH2PO4, peptona, MgSO4 i uree, te pH-vrijednost. Provedeno je ukupno 50 eksperimenata, a dobiveni su podaci bili u skladu s predviđenim optimalnim vrijednostima. Rezultati potvrđuju da se iz kore manga može uspješno proizvesti poligalakturonaza, i to najviše 36,5 U/mL pri optimalnim omjerima (mase po volumenu): KH2PO4 22 %, pepton 0,5 %, MgSO4 0,02 %, urea 0,2 %, te pH-vrijednosti od 5,8. Poligalakturonaza je djelomično pročišćena 3,4 puta i određena je njezina molekularna masa od 34 kDa. Optimalna pH-vrijednost za aktivnost poligalakturonaze bila je 5, a temperatura 55 °C.Pectin-rich mango peel from industrial waste was used as a substrate for the production and characterization of novel polygalactauronase enzyme. Its production was optimized with five important factors; KH2PO4, pH, peptone, MgSO4 and urea by employing response surface methodology using submerged fermentation with Aspergillus foetidus. Total of 50 experimental runs were carried out and the predicted values for optimization were in good agreement with experimental data. The results showed that a satisfactory production of polygalacturonase from the mango peel could be achieved, reaching up to 36.5 U/mL under optimized medium conditions of pH=5.8 and (in %, by mass per volume): KH2PO4 0.22, peptone 0.5, MgSO4 0.02 and urea 0.2 %. The polygalacturonase was partially purified to 3.4-fold and the molecular mass was found to be 34 kDa. The optimum pH and temperature for polygalacturonase activity were 5 and 55 °C, respectively

Prevalence and Impact of Thyroid Disorders on Maternal Outcome in Asian-Indian Pregnant Women

Aims. To establish the prevalence and the effect of thyroid dysfunction on pregnancy outcomes in Asian-Indian population. Subjects and Methods. The study cohort comprised of 483 consecutive pregnant women in the first trimester attending the antenatal clinic of a tertiary center in Mumbai, India. Thyroid hormone levels and thyroid peroxidase antibody were estimated. Patients with thyroid dysfunction were assessed periodically or treated depending on the severity. Subjects were followed until delivery. Results. The prevalence of hypothyroidism, Graves' disease, gestational transient thyrotoxicosis, and thyroid autoimmunity (TAI) was 4.8% (n = 24), 0.6% (n = 3), 6.4 % (n = 31), and 12.4% (n = 60), respectively. Forty percent of the hypothyroid patients did not have any high-risk characteristics. Hypothyroidism and TAI were associated with miscarriage (P = 0.02 and P = 0.001, resp.). Conclusions. The prevalence of hypothyroidism (4.8%) and TAI (12.4%) is high. TAI and hypothyroidism were significantly associated with miscarriage